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Bender JM, Adams WR, Mahadevan-Jansen A, et al. Radiofrequency ablation alters the microstructural organization of healthy and enzymatically digested porcine mitral valves. Exp Mech. 2020;61(1):235-251doi: 10.1007/s11340-020-00662-w.
Bender, J. M., Adams, W. R., Mahadevan-Jansen, A., Merryman, W. D., & Bersi, M. R. (2021). Radiofrequency ablation alters the microstructural organization of healthy and enzymatically digested porcine mitral valves. Experimental mechanics, 61(1), 235-251. https://doi.org/10.1007/s11340-020-00662-w
Bender, J M, et al. "Radiofrequency ablation alters the microstructural organization of healthy and enzymatically digested porcine mitral valves." Experimental mechanics vol. 61,1 (2021): 235-251. doi: https://doi.org/10.1007/s11340-020-00662-w
Bender JM, Adams WR, Mahadevan-Jansen A, Merryman WD, Bersi MR. Radiofrequency ablation alters the microstructural organization of healthy and enzymatically digested porcine mitral valves. Exp Mech. 2021 Jan;61(1):235-251. doi: 10.1007/s11340-020-00662-w. Epub 2020 Oct 26. PMID: 33776074; PMCID: PMC7992362.
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Exp Mech. 2021 Jan;61(1):235-251. doi: 10.1007/s11340-020-00662-w. Epub 2020 Oct 26.

Radiofrequency ablation alters the microstructural organization of healthy and enzymatically digested porcine mitral valves.

Experimental mechanics

J M Bender, W R Adams, A Mahadevan-Jansen, W D Merryman, M R Bersi

Affiliations

  1. Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.

PMID: 33776074 PMCID: PMC7992362 DOI: 10.1007/s11340-020-00662-w

Abstract

BACKGROUND: Myxomatous mitral valve degeneration is a common cause of mitral regurgitation and is often associated with mitral valve prolapse. With no known targets to pharmacologically treat mitral valve prolapse, surgery is often the only treatment option. Recently, radiofrequency ablation has been proposed as a percutaneous alternative to surgical resection for the reduction of mitral valve leaflet area.

OBJECTIVE: Using an in vitro model of porcine mitral valve anterior leaflet enlargement following enzymatic digestion, we sought to investigate mechanisms by which radiofrequency ablation alters the geometry, microstructural organization, and mechanical properties of healthy and digested leaflets.

METHODS: Paired measurements before and after ablation revealed the impact of radiofrequency ablation on leaflet properties. Multiphoton imaging was used to characterize changes in the structure and organization of the valvular extracellular matrix; planar biaxial mechanical testing and constitutive modeling were used to estimate mechanical properties of healthy and digested leaflets.

RESULTS: Enzymatic digestion increased leaflet area and thickness to a similar extent as clinical mitral valve disease. Radiofrequency ablation altered extracellular matrix alignment and reduced the area of digested leaflets to that of control. Additionally, enzymatic digestion resulted in fiber alignment and reorientation toward the radial direction, causing increased forces during ablation and a structural stiffening which was improved by radiofrequency ablation.

CONCLUSION: Radiofrequency ablation induces radial extracellular matrix alignment and effectively reduces the area of enlarged mitral valve leaflets. Hence, this technique may be a therapeutic approach for myxomatous mitral valve disease and is thus an avenue for future study.

Keywords: ablation; biaxial; mechanics; microscopy; mitral; multiphoton; percutaneous; prolapse; radiofrequency; therapy; valve

Conflict of interest statement

Conflict of Interest: The authors declare that they have no conflict of interest.

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